Online Conference Registration

EARLY BIRD REGISTRATION FORM
OPHTHALMOLOGICAL SOCIETY OF THE WEST INDIES (OSWI)

30TH ANNUAL CONGRESS, JULY 10– 13, 2019

HYATT REGENCY TRINIDAD, WEST INDIES

You can also download the offline registration form here: Download

OSWI #:
 
Personal Details:
 
Surname *:
First Name *:
Middle Name:
 
Degree:
 
Business Tel *:
FAX #:
Home # *:
 
Mailing Address:
E-mail *:
 
OSWI MEMBERSHIP LEVEL SelectActive ($325) *Associate ($325) *General Practitioner ($350) *Honorary ($0)Non Member Ophthalmologist ($425) *Nurses/Technicians ($150) *Ophthalmic Assistants ($150
SelectResidents ($150) *Medical Students ($100) *

 
1. I will be accompanied by:
 
Number of Members (US$):Select12345678910
Number of Adults (+0 USD):Select12345678910
Number of Children (+0 USD):Select12345678910
 
2. Please select number of people will be attending the events (family member or your guest also eligible):
 
Golf:Select12345678910
 
5K:Select12345678910
 
Opening Ceremony (Thursday 12th July):Select12345678910
 

Cocktail and President’s Dinner (Friday 13th July):Select12345678910
 
After Conference Party (Saturday 14th July):Select12345678910
 
ENTERTAINMENT FEE(PRESIDENT’S DINNER AND AFTER CONGRESS FUNCTION) (USD $125 per attendee)
4. I WILL BE ARRIVING TRINIDAD ON *:
 
5. I will be staying at Hyatt Regency, Trinidad Yes   No
 
If yes then Book Hotel Now
 
 
 

 

PLEASE NOTE: PLEASE MAKE  BANK DRAFTS PAYABLE TO OSWI                         OR MEMBER CAN PAY VIA PAYPAL AT oswi10@hotmail.com       ALL PAYMENT IN USD CURRENCY ONLY
ALL CHARGES PAYABLE IN $USD CASH, OR CHEQUES (CHEQUES TO BE WRITTEN TO OSWI)
DEADLINE FOR EARLY BIRD REGISTRATION IS MARCH 18^TH 2019 AFTER WHICH A LATE FEE WILL BE CHARGED.
THE LAY SECRETARIAT CAN BE CONTACTED AT THE FOLLOWING:
E-MAIL: oswi10@hotmail.com or infoatoswi@gmail.com